Validity of the retrospective reproductive calendar instrument in developing countries: findings from a prospective and longitudinal study

Katherine Tumlinson, MA, Princeton University

Project abstract

Family planning has been shown to save the lives of women and children living in developing countries. Despite the overwhelming success of family planning programs in many world regions, contraceptive prevalence in much of sub-Saharan Africa remains low and in some countries as many as one in four women experience an unmet need for family planning services and commodities. Additionally, it is estimated that between one third and nearly half of all women using modern reversible contraceptive methods discontinue their method within 12 months of initiation.

Future success of family planning programs in Africa will depend not only on improved rates of contraceptive uptake but also on improvements in contraceptive continuation. A better understanding of the true rate of contraceptive discontinuation as well as factors influencing contraceptive behavior could dramatically impact maternal, infant, and child mortality in this region.

A reproductive calendar is an individual-level survey instrument that collects month-by-month retrospective histories of contraceptive use and details reasons for discontinuation. It is the standard instrument for measuring discontinuation in developing country settings, despite little information on the reliability and validity of this instrument.

The goal of this study, therefore, is to investigate the validity of the calendar using a random sample of contraceptive users followed prospectively over a six-month period. This validation study will quantify the accuracy of the retrospective calendar instrument and ascertain the impact of recall bias on study results. Data will be collected in collaboration with the Measurement, Learning, and Evaluation (MLE) Project at UNC-Chapel Hill.